Published on Oct 21, 2019 - 5 min read
Did you know that a fractured tooth can go unnoticed until it gets infected? Learn about its symptoms, types, causes, and treatment options.
Crown and root are the two parts of a tooth. The root is made up of two hard tissues, enamel and dentin, and the root has dentin and cementum. The center of the tooth (root canal) consists of soft pulp, which contains the nerves and blood vessels. A fracture can include enamel, dentin, cementum, or pulp.
source : wilkdental
While chewing on hard foods, a tooth can fracture or crack. It is also commonly seen in people who grind their teeth at night, play contact sports, or it can occur spontaneously in older adults. It is one of the commonest tooth condition that results in tooth loss.
There are various treatment options available to save a cracked tooth. Unlike a broken bone, a fractured tooth will never be 100 % healed even after treatment, but getting it treated will prevent further damage and spread of infection.
You can protect your teeth by maintaining good oral hygiene, avoid biting on hard foods, and wearing a mouthguard. In most cases, the crack can be seen, but sometimes if the fracture is along the length of the tooth, it is impossible to see them with the naked eye. If you cannot see the fracture, certain symptoms like pain while chewing or sudden sensitivity to hot and cold can be signs of it.
Very small fractures are difficult to diagnose, as it might not cause any symptoms except for pain that occurs on and off. Prompt treatment should be sought after because if left untreated, it can cause severe pain, infection, and tooth loss.
Craze lines - They are minute cracks in the enamel of a tooth. They usually do not result in any pain and need no treatment.
Fractured cusp - It is the fracture of the pointy part of the biting surface of a tooth (cusp). It commonly occurs around a tooth filling and does not involve the pulp. As a result, it does not result in much pain.
Cracked tooth - This type of fracture runs vertical and usually extends into the gum line. If the fracture has not reached the gum line (incomplete crown fracture), the prognosis is good. But the tooth might have to be extracted of the crack extends into the gum line (incomplete crown-root fracture).
Split tooth - It is when the two fractured segments can be separated. Depending on the extent of fracture, the dentist might save one segment of the tooth or extract the entire tooth.
Vertical root fracture - Here, the fracture starts below the gum line and then travels up. It does not cause any symptoms until the tooth gets infected. Usually, such teeth need to be extracted.
source : microendocenter
The common causes of a tooth fracture are:
Bitting on hard food items.
Grinding the teeth at night (bruxism).
Increasing age (above 50 years).
A tooth that has a large dental filling, as it weakens the tooth.
Injury to the chin or jaw during road traffic accidents, contact sports, fall, etc.
Eating something very cold immediately after eating something hot might cause fractures due to temperature change.
Root fractures are commonly seen in people with gum diseases.
Most people do not have any symptoms. Craze lines do not cause any symptoms and do not require treatment. Severe cases results in the following symptoms:
Pain while chewing or biting.
Pain occurs on and off.
Tooth sensitivity to sweet foods.
Tooth feels sensitive to hot and cold foods.
Most of the time, a minor tooth fracture is accidentally diagnosed in an x-ray taken for some other condition. Sometimes fractures do not show up in an x-ray also, this is due to the angle at which the x-ray was taken and the type of fracture.
A dentist will take a complete medical and dental history, and ask you if you chew a lot of hard food or grind your teeth at night. If needed, the dentist might use a magnifying lens or dental dye to look for any cracks.
Your dentist might also ask you to bite on something hard. You might have pain when you release your bite if your tooth is cracked.
Depending on your symptoms, location and size of the fracture, various treatment options are available. Your dentist might suggest one of the following treatment modalities:
1) Bonding or dental filling - If the fracture does not involve the pulp or dentin, the dentist fills the crack using tooth-colored composite resin. In this method, the doctor will etch the surface to make it rough, so the bonding material adheres to the tooth. Then the tooth-colored resin is used to build the fractured part of the tooth, and the material is hardened using ultraviolet light.
2) Dental crown or cap - When the fracture involves the dentin or a lot of tooth portion is lost, then a dental crown or cap is used to cover the damaged tooth. It is tooth-shaped and can be made from metal, metal and ceramic, or all ceramic. It is fitted over the fractured tooth and makes is functionally and aesthetically better. The dentist will first cut the tooth to make space for the dental crown and make an impression, which is sent to the lab. The lab will fabricate the crown depending on the patient’s bite and tooth color.
3) Root canal treatment - If the crack is extensive and it involves the pulp or if it has resulted in the infection of the pulp, then root canal treatment is necessary. Here, the infected pulp in the root canal is removed and the root canal is shaped and prepared. Then the root canal is filled with a biocompatible material and a dental crown is placed on the tooth to increase strength and appearance.
4) Extraction - Your dentist will extract the tooth only if the tooth is damaged beyond repair.
Craze lines and other hairline cracks in the enamel do not cause any symptoms and need no treatment.
The complications of a fractured tooth are:
Pain on biting.
Swollen glands in the neck.
To prevent this condition, avoid biting on hard foods, maintain good oral hygiene, and ask your dentist for a mouthguard. For more information, consult a dentist online.
Query: Hello doctor, When I was 11 years old, I was knocked off my bike and cracked my front tooth in half horizontally, shortly after the dentist fixed it. Since then I have had no problems with it and had multiple x-rays to check on it. When it happened, the color of the tooth changed very slightly, to ... Read Full »
Query: Hi doctor,I have tooth sensitivity problem. I am suffering from this problem since last two months. I am unable to drink water also. I tried many sensitivity toothpastes, but it does not work properly. Please suggest me a proper drug or suggestion for instant relief. Read Full »
Query: Hello doctor, My bottom teeth were drilled for a root canal but after drilling doctor told that my teeth have a split and he filled that hole with a cavity. From the past one year, my gum was swollen and bad smell is coming out from that teeth. From the past one month, I have had bumps on my back o... Read Full »
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